TITLE:
Cardiac Manifestations with Chemotherapeutic Agents: 5 Fluorouracil-Induced Coronary Artery Vasospasm
AUTHORS:
Vignendra Ariyarajah, Mohamed S. Hameed, Mohamed Firdaus M. Mydeen, Guillermo J. Crespo
KEYWORDS:
5-Fluorouracil, Chemotherapeutic Agent, Cardiotoxicity, Vasospasm
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.13 No.8,
August
31,
2023
ABSTRACT: 5-fluorouracil
(5-FU) is a fluorinated, pyrimidine analog, antineoplastic agent that is used
in the treatment of several solid organ cancers. Cardiotoxicity is uncommon but
life-threatening manifestations such as myocardial infarction may manifest
owing to 5-FU-induced coronary artery spasm. Administering smaller doses of the
drug, more frequently than not, decreases the risk of cardiotoxicity compared
to large doses or with continuous infusions. We present a case of ST-segment
elevation in a patient without known coronary artery disease who had presented following continuous 5-FU infusion. Coronary angiogram confirmed absence of coronary
artery disease and intravenous calcium channel blockers administration
was commensurate with the patient’s improvement in symptoms. We discuss the
literature on 5-FU and its association with coronary artery spasm, and also
briefly review chemotherapy-induced
cardiotoxicities to help better prepare internists and other primary
health care providers to face similar challenges, particularly of the uncommon
but potentially life-threatening manifestations.